ERCP...

First off I'm a 19 year old female.  I had my gallbladder removed in Febuary this year.  I continued having RUQ pain and had been in the ER 5 times since the removal. I was sent to a Gastrologist, who did a gastric endoscopy and everything turned out fine.  Then I was recommended to a specialist who first believed I had IBS. I was taken off lactose, and put on a low dose of endap.  No change still ended up in the ER for pains.  Just this last week I ended up going in for an ERCP.  (I had a consoltation scheduled, but I ended up going to the ER again and they bumped up the procedure to the next day)  I should point out right now, I have no stones, and no signs of the bile duct dialated.  They believed that there could be scar tissue irritating the bile duct, along with IBS.  Well, when they went in they ended up putting a stent in the pancreatic duct, and tried to go into the biliary duct, however it was too narrow and started inflamming too much that he had to stop the procedure.  So here comes my first question:

Could my bile duct be so narrow causing the pain in the first place?

I ended up staying in the hospital for 2 days after the procedure, due to increased enzyme levels, mild case of nausea, and pain.  I also had bowel gas pain pretty bad, which is understandable since they push air into the intestine, as well as morphine slows down the intestines causing gas to form and just sit there.  Well, I'm home now 3 days after the ERCP, with mild tenderness, and gas pain every once in a while.  So my second question:

Is tenderness a common side effect after an ERCP?  And if so, how long does it usually last?

Since the first procedure wasn't successful, I am lucky enough to go back in on the 25th for another one, after my organs settle back down from inflammation.  YAY...not.
Any help on this would be great! :-D
THANKS

[Child Divisum]

My daughter has pancreatic divisum and she has had two operations to help to open up the bile duct from her divided pancreas.  Her ducts were so narrow as a result of the divisum that when she underwent her first ERCP they could not even get to scope to the pancreas.  Of course she also had major inflammation in all of her organs as a result of the cyst and pancreatic enzymes.  er duct was so narrow that after her 9 years of life, pancreatic fluid built up on her pancreas and formed a large psuedocyst on the pancreas itself.  With respect to your second question, her doctors have said that she may be in for another ERCP if she has another attack of pancreatitis or if the attack she is currently going through does not stop.  They also mentioned putting in a stint if her ducts have dialated again.  However, they will not perform the ERCP while she is experiencing pancreatitis as the procedure itself can in fact cause pancreatitis or inflammation, as you well know.  Which I if that is why you have the tenderness.  I wish you the best of luck on the 25th for the other ERCP and I will pray that you come out of it with answers and solutions for your pain and discomfort.  

[ky_sunshine]

the complications of ercp does cause pain and tenderness, ive had 2 stents put in the pancreatic duct and one in the bile dict and everytime i have gas, diarrea (diarrhea)(excuse the spelling) and pain that comes with pancreatits.  Everytime i have an ercp i get pancreatits and with every ercp the pancreatitis gets worse.  I know you dont want to hear that but I wish i would have had that information in the begining so that i could have prepared for it.   the pancreatits usually subsides after 3-4 days and tenderness usually goes away within a week if everything calms down ok.  good luck on your next ercp, just keep in mind that the stents are usually temporary relief for 3-6 months and then it starts to come back again.  thats the battle im facing right now.  stay in touch, the more infomation we can share hopefully the better off we all will be.

God bless
Melinda

[Curls]

Do your doctors have any suggestions for how to get you off the cycle of ERCP to replace the stent?  My dad is facing the same problem with replacements every two months.  I wrote a post about it "stricture in pancreas duct from ercp" with the details, so I skip repeating them here.

The ERCP to remove a benign growth seemed to be a delayed trigger for an attack and the stent rubbed and caused a stricture, that's triggering more attacks...  About every 3 months the narrow duct gets blocked up and then the attack happens.  He's been to some of the best specialists and they are saying he's not a candidiate for the surgery which is a tough surgery anyway.  After the first attack the original idea was to keep replacing the stents with larger ones until it was strong and large enough, but he seemed to be in the small percentage for whom that doesn't work.  

Is there anything the docs are telling you down the road to try?  Any thoughts you've had on it?  As you said, the more we share, the better the chances that one of us will ultimately find a good idea.

Dreamy - my dad's length of reaction seems to vary with the intensity of the procedure.  You had a lot done, so it sounds reasonable...

[dreamynothing]

Wow, i'm kinda depressed to find out that the stents need to be replaced over time...

I'm still sore...I just want this whole nightmare to be over...but the more I talk to people I find out that this isn't so uncommon with people...and I always hear how people just live with it....

it's just not right

[ky_sunshine]

i agree with you....it really is just not right.  im having one a of my worst nights tonight the kind of night where even pain meds arent helping my stomach is sore to the touch and it burns in the front and up my back.  I've got an appointment to see my gastro. spec. tomorrow. ill post what his suggestions are for me since ive had 2 stents this year already.  My first one was 1 year ago to the day.  My best wishes to you maybe you'll be one of the lucky one's and the next ercp will b you're last.  My doc didn't expect to see me for another year or 2......

[Curls]

Dreamy - stents don't need to be replaced regularly.  That's a small percentage of people in whom they are placed.  Usually temp ones are used that fall out and then everything is fine.  Even when a stricture is caused, they keep putting in bigger ones to stretch it until a permanent can be put in or it holds on it's own.  Unfortunately my dad's isn't stretching enough for the bigger ones and isn't holding.

Ky_sunshine - I don't know if you saw my question above, but please do post what your gastro says.  Any sharing of ideas would help.

[dreamynothing]

ok so this might sound like a stupid question...when the temp stents come out...or fall out...do u like just poop them out?

[ky_sunshine]

yes u do in about 2 weeks, you'll never know anything, it's so small you wont be able to see it.  How are you feeling?  Better I hope.

[dreamynothing]

I just got back from my ECRP...my 2nd one
This time they did get into the bile duct...they said that they dug out some small stones that were all broken up and formed like a gravel/sludge stuff, and that it was causing pain.

I'm sore right now, kinda freaked out because my stool is really dark almost black....is that ok?!

I had a fever last night when I got home of 102...and was throwing up, but right now I'm feeling better, my temp is down to 99 and i'm keeping stuff down

[ky_sunshine]

i know it's been a couple of days since your post how are you feeling now?  you shouldnt have ran a temp or had dark stools did you call your gastro?  Drop me a post and let me know how you are ok?

[dreamynothing]

Today I've had a few more pains....tolerable though...but lately I havn't had any...

And my stool today was real loose and real dark (almost black)

I don't know what's going on

[CYNDI1]

I also had an ERCP in August for gallstones and the GI Dr made a sphincter for the bile to drain..
my body did not come back to "normal" till I had my Gall bladder removed in Oct....
I must say I have not had any problems but have maintained a Fat Free diet for 90% of the time...
my Liver functions tests were off the charts and are still abnormal but somewhat better...I guess it takes a while for any normalcy...
did you have a removal of your Gall bladder? The sludge can be taken care of with a med called Urisol (tastes awful) however you may suggest it to your GI person...
Cyndi 1